Teacher Input Form

This confidential input form is to be filled out by the teacher and not the student. It is used to prepare the school report that HPA submits to colleges on behalf of our students. The deadline for submitting this form is May 1, 2012.

Thank you!

Student name: *

Teacher's name: *

Teacher's e-mail: *

Course or activity:

List 5-6 adjectives that describe this student’s character and personality.: *

What personal or academic growth have you witnessed in this student?: *

What does this student add to your classroom? What would be missing if he or she was absent?: *

What are this student’s best academic skills and learning style?: *

eg. written expression, discussion, insightful questions, creativity, daily preparation, determination, group work, collaboration, etc.

Please provide a specific anecdote that illustrates one or more of these academic qualities: *

STUDENT RATINGS

How do you rate this student in terms of: *

	No Basis	Below Average	Average	Above Average	Good	Very Good	Excellent (top 10%)	Outstanding (top 5%)	Top few (top 1%)
Academic achievement
Intellectual promise
Quality of writing
Creative, original thought
Productive class discussion
Respect accorded by faculty
Disciplined work habits
Maturity
Motivation
Leadership Integrity
Reaction to setbacks
Concern for others
Self-confidence
Initiative, independence
OVERALL

This information is necessary for the College Counseling Center to complete this student's college application forms. Please evaluate this student compared with others in his or her class.

Additional comments:

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Teacher Input Form

Academics

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